Medicare coverage of evidence-based tobacco-cessation counseling expanded

WASHINGTON The Department of Health and Human Services on Wednesday expanded Medicare coverage of evidence-based tobacco-cessation counseling, removing a barrier to treatment for all tobacco users covered by Medicare, the Centers for Medicare and Medicaid Services announced.

 

Before that decision, Medicare had covered tobacco counseling only for individuals diagnosed with a recognized tobacco-related disease or those who showed signs or symptoms of such a disease. Under the new coverage, any smoker covered by Medicare will be able to receive tobacco-cessation counseling from a qualified physician or other Medicare-recognized practitioner who can work with the smoker to help him or her stop using tobacco. All Medicare beneficiaries will continue to have access to smoking-cessation prescription medication through the Medicare Prescription Drug Program.

 

“For too long, many tobacco users with Medicare coverage were denied access to evidence-based tobacco-cessation counseling,” stated HHS secretary Kathleen Sebelius. “Most Medicare beneficiaries want to quit their tobacco use. Now, older adults and other Medicare beneficiaries can get the help they need to successfully overcome tobacco dependence.”

“Today’s decision builds on the existing preventive services that are available to Medicare beneficiaries,” added CMS administrator Don Berwick. “Giving older Americans and persons with disabilities who rely on Medicare the coverage they need for counseling treatments that can aid them in quitting will have a positive impact on their health and quality of life. As a result, all Medicare beneficiaries now have more help to avoid the painful — and often deadly — consequences of tobacco use.”

The new benefit will cover two individual tobacco-cessation counseling attempts per year. Each attempt may include up to four sessions, with a total annual benefit thus covering up to eight sessions per Medicare patient who uses tobacco.

Today’s final coverage decision will apply to services under Parts A and B of Medicare and does not change the existing policies for Part D, or any state-level policies for Medicaid or the Children’s Health Insurance Program. HHS will issue guidance in the coming months about a new benefit for pregnant women to receive Medicaid-covered tobacco-cessation counseling. This new benefit, a provision of the Affordable Care Act, requires states to make coverage available to pregnant Medicaid beneficiaries by Oct. 1.